Objectives In 2015, a healthcare reform was undertaken in the province of Quebec (Canada). This amended system resources and structures, resulting in increased work-related stress, retirements, and sick leaves. In this study, we examined associations between stress, psychological distress, and resilience in this context. Methods A subsample of healthcare workers (n = 1008) from the 2014-2015 Eastern Townships population-based survey was used to examine resilience, its distribution among various occupational categories, and whether it moderated associations between stress and psychological distress. Chi-square analyses were used to look for differences between variables. Logistic regressions served to assess the moderating effect of resilience in the associations between stress and psychological distress. Results Healthcare workers' resilience was high. Employees with higher resilience are more likely to be older, male, educated, and affluent. One third of workers reported their work as quite or extremely stressful, 56.2% rated it as their main source of stress, and 25.7% reported psychological distress. Despite higher stress, administrators had higher resilience and lower psychological distress. Support staff had higher psychological distress and lower resilience. Occupation involving social staff, technicians, and professionals had higher psychological distress despite lower stress. A positive gradient in the distribution of resilience was observed in the healthcare system hierarchy with higher resilience and lower psychological distress among higher positions (despite equal stress). Higher resilience moderates the negative association between stress and psychological distress. Conclusion These results support workplace health promotion to foster employee health, particularly in the lower spectrum of the healthcare system hierarchy. Résumé Objectifs En 2015, une réforme du réseau de la santé a été entreprise au Québec. Celle-ci a généré une augmentation du stress, des départs à la retraite et des congés maladies. Cette étude examine les associations entre le stress, la détresse psychologique et les capacités d'adaptation. Méthodes Un échantillon de travailleurs de la santé (n = 1008) issu de l'enquête populationnelle sur la santé des estriens (2014-2015) a permis d'examiner la résilience et sa distribution entre diverses catégories professionnelles et de déterminer son rôle modérateur dans l'association entre le stress et la détresse psychologique. Des analyses de chi-carré ont documenté des différences entre les variables. Des régressions logistiques ont évalué le rôle modérateur de la résilience.